Alopecia Areata Diagnosis

The most characteristic feature of alopecia areata is having a clear marked patch of hair-loss in the scalp. It is mostly a round/oval smooth patch surrounded by areas with normal hair growth. Sometimes thin white hair grows in the bald patch/patches after a few months. Patients feel distressed and upset to see clumps of hair falling off in the shower or on the pillow and sudden visible bald patches on the scalp.

GP/Specialist consult

When you see suddenly a patch of bald scalp, you may feel panicky and go to the doctor. A physical examination will be conducted and the doctor will ask about your medical history. He will look at the pattern of hair loss, and conduct a scalp examination. If the area infected looks expanding, the doctor will pull out some hair for hair analysis. He may check for the presence of yellow-color skin deposit around hair follicles, fractured short hairs. He will check your nails.

Tests/Procedures

To confirm the diagnosis of alopecia areata, he will do

Hair analysis – look at your hair sample under microscope.

Biopsy – A small skin sample is taken from the scalp and a biopsy is done (optional).

Blood tests – Are ordered only if the dermatologist suspects the presence of other coexistent autoimmune disease like an overactive/underactive thyroid gland.

Elimination of other hair-loss causes

The doctor will rule out other diseases causing hair loss and may be mistaken for alopecia areata such as

Trichotillomania – A psychic condition where the patient manually pulls the hair out.

Secondary syphilis – Where moth-eaten type baldness all over the scalp is present.

Dermoscopy

Dermoscopy is a recent pioneering procedure to evaluate hair loss. Its role in alopecia diagnosis is still in the initial stages. It is a simple and safe method to identify specific features that occur in alopecia areata only like – tapering hairs, cluster of short hairs, broken hairs, and some black dots. Most importantly, it confirms the presence of yellow color matter that cluster at hair follicles specific only to alopecia areata and not found in other alopecia conditions.

Prognosis

Mostly the fallen hair re-grows by itself, and treatment can speed up the growth. Appropriate counseling is essential for the distressing and damaging psychological impact. Camouflaging with suitable cosmetics until hair re-grows can hide the bald patches.

About

Dr. Batul Patel is the Director of The Bombay Skin Clinic located in South Mumbai. She is a passionate and dedicated dermatologist with expertise in all fields of dermatology, trichology and aesthetic dermatology. Having completed her M.B.B.S., D.D.V. and M.D., she has been practicing for more than 10+ years. Her range of expertise include pediatric dermatology, anti-aging, lasers, skin rejuvenation, hair loss, PRP, acne & pigmentation treatments. She was a consultant with Allergan and has trained many dermatologists.Know more